A turn towards dying: presence, signature, and the social course of chronic illness in urban America.

This article examines an account of chronic illness and traces the narrative as it turns towards dying. Based on two years of ethnographic work with one household in Baltimore, MD, the article illustrates the complex institutional transactions performed by the poor in the urban United States. The ethnography follows the contours of these transactions as they take shape between biomedical and domestic spheres, considering the way in which the management of illness reconstitutes social arrangements. The focus is on the female head of household, following her through clinic visits, hospitalizations, and the care of her grandchildren, adult children, and ailing mother. The article suggests that the notion of dying without an institutional signature compels a reassessment of what illness unto death can mean in clinical and nonclinical contexts, and in doing so, demonstrates how dying becomes defined through its social course within the everyday.